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Hung YP, Dong F, Torre M, Crum CP, Bueno R, Chirieac LR. Molecular characterization of diffuse malignant peritoneal mesothelioma. Mod Pathol 2020; 33:2269-2279. [PMID: 32504035 DOI: 10.1038/s41379-020-0588-y] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 05/23/2020] [Accepted: 05/24/2020] [Indexed: 01/31/2023]
Abstract
Malignant peritoneal mesothelioma is a rare aggressive tumor that arises from the peritoneal lining. While recurrent BAP1 mutations have been identified in a subset of mesotheliomas, molecular characteristics of peritoneal mesotheliomas, including those lacking BAP1 alterations, remain poorly understood. Using targeted next-generation sequencing, we examined the molecular features of 26 diffuse malignant peritoneal mesotheliomas. As part of an exploratory analysis, we analyzed an additional localized peritoneal mesothelioma and one well-differentiated papillary mesothelioma with invasive foci. Genomic characterization identified categories of diffuse malignant peritoneal mesotheliomas: The first group included 18 (69%) tumors with recurrent BAP1 alterations, with eight (31%) having more than one BAP1 alterations, and concomitant alterations in PBRM1 (46%) and SETD2 (35%). All tumors with complete loss of BAP1 expression by immunohistochemistry harbored BAP1 molecular alterations. PBRM1 alterations were significantly enriched in the BAP1-altered cohort. Frequent copy number loss of BAP1, ARID1B, PRDM1, PBRM1, SETD2, NF2, and CDKN2A was noted. The second group included eight (31%) BAP1-wild-type tumors: two with TP53 mutations, one with a TRAF7 activating mutation, one with a SUZ12 inactivating mutation, and three with ALK rearrangements that we previously published. One TP53-mutant biphasic mesothelioma showed evidence of genomic near-haploidization showing loss of heterozygosity of all chromosomes except 5, 7, 16, and 20. The localized peritoneal mesothelioma harbored a nonsense CHEK2 mutation, and the well-differentiated papillary mesothelioma with invasive foci harbored no reportable variants. In conclusion, we described the genetic categories of diffuse malignant peritoneal mesotheliomas, with BAP1-mutant and BAP1-wild-type groups. Our findings implicated DNA repair, epigenetics, and cell cycle regulation in the pathogenesis of peritoneal mesotheliomas, with identification of potential therapeutic targets.
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Affiliation(s)
- Yin P Hung
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA. .,Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
| | - Fei Dong
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Matthew Torre
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Christopher P Crum
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Raphael Bueno
- Department of Surgery, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Lucian R Chirieac
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
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Vermersch S, Arnaud A, Orbach D, Andre N, Berger C, Kepenekian V, Brigand C, Fresneau B, Poli-Merol ML, Habougit C, Varlet F, Scalabre A. Multicystic and diffuse malignant peritoneal mesothelioma in children. Pediatr Blood Cancer 2020; 67:e28286. [PMID: 32277799 DOI: 10.1002/pbc.28286] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 02/20/2020] [Accepted: 03/02/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND Malignant and multicystic peritoneal mesotheliomas are extremely rare tumors in children, developing from mesothelial cells. No specific guidelines are available at this age. METHODS We performed a retrospective analysis of all identified children (< 18-year-old) treated in France from 1987 to 2017 for a diffuse malignant peritoneal mesothelioma (DMPM) or a multicystic peritoneal mesothelioma (MCPM). RESULTS Fourteen patients (5 males and nine females), aged 2.2 to 17.5 years, were included. The most frequent presenting symptoms were abdominal pain, ascitis, and alteration in the general condition. Eight patients had epithelioid mesothelioma, three had biphasic mesothelioma, and three had MCPM. Eight patients with DMPM diagnosis received cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC). Among them, six patients had neoadjuvant systemic chemotherapy, one patient, post-operative chemotherapy, and one patient CRS and HIPEC only. Three patients received only systemic chemotherapy. All patients with MCPM had only surgery. After a median follow-up of seven years (2-15), six patients (6/11; one death) with DMPM and two patients (two/three) with MCPM had a local and distant recurrences. CONCLUSION Peritoneal mesothelioma in children is a rare condition with difficult diagnosis and high risk of recurrence. Worldwide interdisciplinary collaboration and networking are mandatory to help diagnosis and provide harmonious treatment guidelines.
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Affiliation(s)
- Sophie Vermersch
- Department of Pediatric Surgery, University Hospital of Saint-Etienne, Saint-Priest-en-Jarez, France
| | - Alexis Arnaud
- Department of Pediatric Surgery, University Hospital of Rennes, Rennes, France
| | - Daniel Orbach
- SIREDO Oncology Center, Institut Curie, PSL University, Paris, France
| | - Nicolas Andre
- Department of Pediatric Hematology and Oncology, La Timone Children's Hospital, Marseille, France
| | - Claire Berger
- Department of Pediatric Oncology, University Hospital of Saint-Etienne, Saint-Priest-en-Jarez, France
| | - Vahan Kepenekian
- Department of Adult Surgical Oncology, University Hospital of Lyon, Lyon, France
| | - Cécile Brigand
- Department of Digestive Surgery, Strasbourg University, Strasbourg, France
| | - Brice Fresneau
- Department of Children and Adolescents Oncology, Institut Gustave Roussy, Paris, France
| | | | - Cyril Habougit
- Department of Pathology, University Hospital of Saint-Etienne, Saint-Priest-en-Jarez, France
| | - François Varlet
- Department of Pediatric Surgery, University Hospital of Saint-Etienne, Saint-Priest-en-Jarez, France
| | - Aurélien Scalabre
- Department of Pediatric Surgery, University Hospital of Saint-Etienne, Saint-Priest-en-Jarez, France
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Hung YP, Dong F, Watkins JC, Nardi V, Bueno R, Dal Cin P, Godleski JJ, Crum CP, Chirieac LR. Identification of ALK Rearrangements in Malignant Peritoneal Mesothelioma. JAMA Oncol 2019; 4:235-238. [PMID: 28910456 DOI: 10.1001/jamaoncol.2017.2918] [Citation(s) in RCA: 76] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Importance Malignant peritoneal mesothelioma is a rare, aggressive tumor arising from the peritoneal lining, induced by asbestos, therapeutic radiation, or germline mutations. Nevertheless, the molecular features remain largely unknown. Objective To investigate anaplastic lymphoma kinase (ALK) rearrangements in a large series of peritoneal mesothelioma and characterize the mutational landscape of these tumors. Design, Setting, and Participants We studied 88 consecutive patients (39 men, 49 women; median age 61, range 17-84 years) with peritoneal mesotheliomas diagnosed at a single institution between 2005 and 2015. We identified ALK-positive mesotheliomas by immunohistochemistry and confirmed ALK rearrangement by fluorescence in situ hybridization (FISH). In ALK-rearranged cases, we characterized the fusion partners using targeted next-generation sequencing of both tumor DNA and RNA. In select cases, we quantified asbestos fibers by combined scanning electron microscopy and x-ray spectroscopy. We also explored ALK rearrangement in a separate series of 205 patients with pleural mesothelioma. Main Outcomes and Measures Identification and characterization of novel ALK rearrangements and correlations with clinicopathologic characteristics. Results Anaplastic lymphoma kinase was positive by immunohistochemistry in 11 (13%) peritoneal mesotheliomas (focal weak in 8, diffuse strong in 3). In focal weak ALK-positive cases, no ALK rearrangement was detected by FISH or next-generation sequencing. In strong diffuse ALK-positive cases, FISH confirmed ALK rearrangements, and next-generation sequencing identified novel fusion partners ATG16L1, STRN, and TPM1. Patients with ALK-rearranged peritoneal mesotheliomas were women and younger than patients without ALK rearrangement (median age 36 vs 62; Mann-Whitney test, P = .02), but all other clinicopathologic characteristics (size of tumor nodules, histology, treatment, and survival) were not different. No asbestos fibers were detected in ALK-rearranged cases. Furthermore, loss of chromosomal region 9p or 22q or genetic alterations in BAP1, SETD2, or NF2 typically present in peritoneal mesothelioma were absent in the ALK-rearranged cases. All pleural mesotheliomas were ALK-negative by immunohistochemistry. Conclusions and Relevance We identified unique ALK rearrangements in a subset of patients with peritoneal mesothelioma, each lacking asbestos fibers, therapeutic radiation, and cytogenetic and molecular alterations typically found in these tumors. Identification of clinically actionable ALK rearrangements may represent a novel pathogenetic mechanism of malignant peritoneal mesothelioma with promise for targeted therapy.
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Affiliation(s)
- Yin P Hung
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston
| | - Fei Dong
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston
| | - Jaclyn C Watkins
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston
| | - Valentina Nardi
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston
| | - Raphael Bueno
- Department of Surgery, Brigham and Women's Hospital and Harvard Medical School, Boston
| | - Paola Dal Cin
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston
| | - John J Godleski
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston
| | - Christopher P Crum
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston
| | - Lucian R Chirieac
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston
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Hung YP, Chirieac LR. Novel insights and recent discoveries on the genetics and pathogenesis of malignant mesothelioma. J Thorac Dis 2018; 10:1314-1317. [PMID: 29708148 PMCID: PMC5906283 DOI: 10.21037/jtd.2018.03.33] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 02/14/2018] [Indexed: 11/06/2022]
Affiliation(s)
- Yin P Hung
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Lucian R Chirieac
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
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Yang Y, Gunawardane D, Moffat D, Carter C. Metastatic primary peritoneal malignant mesothelioma mimicking primary diffuse gastric carcinoma: a rare encounter in gastric biopsy. Pathology 2017; 49:317-319. [PMID: 28245936 DOI: 10.1016/j.pathol.2016.11.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Accepted: 11/04/2016] [Indexed: 11/25/2022]
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Berger GK, Gee K, Votruba C, McBride A, Anwer F. Potential application and prevalence of the CD30 (Ki-1) antigen among solid tumors: A focus review of the literature. Crit Rev Oncol Hematol 2017; 113:8-17. [PMID: 28427526 DOI: 10.1016/j.critrevonc.2017.02.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2016] [Revised: 01/26/2017] [Accepted: 02/15/2017] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND CD30 (Ki-1) is a cell membrane protein derived from the tumor necrosis factor (TNF) receptor family. The CD30 antigen has been associated primarily with Hodgkin lymphoma (HL) and systemic anaplastic large cell lymphoma (sALCL). Brentuximab vedotin (BV) is an antibody-drug conjugate targeting the CD30 antigen. FDA approval for BV includes relapsed and refractory HL and sALCL. The CD30 antigen also has been identified in many solid tumors, predominantly of germ cell origins and early clinical data is promising. OBJECTIVE Perform a focus literature review evaluating the prevalence of the CD30 antigen among nonlymphomatous tumors with a potential correlate for CD30 targeted therapy. ELIGIBILITY CRITERIA Inclusion criteria: all retrospective reviews and case reports citing CD30 positivity or negativity in non-lymphomatous malignancies in which data were presented based on location. EXCLUSION CRITERIA studies with hematopoetic malignancies, cutaneous malignancies, non-human populations, and non-english publications. INCLUDED STUDIES A total of 119 articles met these criteria and are summarized in this manuscript. CONCLUSION The CD30 antigen has shown variable prevalence among non-hematopoetic tumors, most notably among germ cell tumors and mesothelioma. With additional, preclinical and properly powered clinical studies, CD30 targeted therapy such as that of BV, alone or in combination with other agents may prove to be a strong candidate in the treatment of various CD30+ malignancies.
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Affiliation(s)
- Garrett K Berger
- College of Pharmacy, University of Arizona, Tucson, AZ, 85721, United States; Hematology, Oncology, Blood & Marrow Transplantation, Department of Medicine, University of Arizona, Tucson, AZ, 85721, United States.
| | - Kevin Gee
- College of Medicine, University of Arizona, Tucson, AZ, 85721, United States
| | - Cassandra Votruba
- College of Pharmacy, University of Arizona, Tucson, AZ, 85721, United States
| | - Ali McBride
- College of Pharmacy, University of Arizona, Tucson, AZ, 85721, United States; Hematology, Oncology, Blood & Marrow Transplantation, Department of Medicine, University of Arizona, Tucson, AZ, 85721, United States
| | - Faiz Anwer
- Hematology, Oncology, Blood & Marrow Transplantation, Department of Medicine, University of Arizona, Tucson, AZ, 85721, United States
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Chirac P, Maillet D, Leprêtre F, Isaac S, Glehen O, Figeac M, Villeneuve L, Péron J, Gibson F, Galateau-Sallé F, Gilly FN, Brevet M. Genomic copy number alterations in 33 malignant peritoneal mesothelioma analyzed by comparative genomic hybridization array. Hum Pathol 2016; 55:72-82. [DOI: 10.1016/j.humpath.2016.04.015] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Revised: 04/01/2016] [Accepted: 04/16/2016] [Indexed: 11/26/2022]
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Brevet M. Comparative genetics of diffuse malignant mesothelioma tumors of the peritoneumand pleura, with focus on BAP1 expression. Pleura Peritoneum 2016; 1:91-97. [PMID: 30911612 DOI: 10.1515/pp-2016-0007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Accepted: 05/04/2016] [Indexed: 12/27/2022] Open
Abstract
Malignant mesothelioma (MM) is a malignancy arising from the mesothelial cells lining the thoracic and abdominal serosal cavities. The pleural space is the most commonly affected site, accounting for about 80% of cases, while peritoneum makes up the majority of the remaining 20%. The different types of mesotheliomas are generally considered as distinct diseases with specific risk factors, therapeutic strategies and prognoses. Epidemiological and clinical differences between pleural and peritoneal MM raise questions about the involvement of different molecular mechanisms. Since the BAP1 gene is involved in the BAP1 cancer syndrome and seems to be a prognostic factor in MM, this review presents an overview of BAP1 alterations in mesothelioma comparing pleural and peritoneal localizations.
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